Learn about the Causes and Treatment Options for Diabetic Foot Ulcer

Treatment Options for Diabetic Foot UlcerPoorly controlled diabetes often results in complications such as foot ulcers, usually occurring at the bottom/top of toes, pad of foot, or heel of foot. A diabetic foot ulcer is an open sore caused by neuropathic (nerve) and vascular (blood vessel) complications of the disease. Foot ulcers are prone to infection, which may even lead to lower extremity amputation. This can be prevented by following certain protocols such as regular observation and objective measurement of the wound with digital photography, and accurate documentation of the wound healing process using a wound EMR. There needs to be good communication among the patient, doctor and the wound healing team for optimum care and better outcome.

An infection is a serious complication of a foot ulcer and requires immediate treatment. Diabetes causes the blood vessels of the feet and leg to narrow and harden. This leads to poor circulation (blood flow), which makes it difficult for your foot to fight infection and heal.

The most common risk factors for ulcer formation include:

  • diabetic neuropathy
  • structural foot deformity
  • kidney disease
  • obesity
  • peripheral arterial occlusive disease

Due to high-pressure areas under the foot, calluses may form and build up faster on the feet of individuals with diabetes. Calluses, when untrimmed can turn into ulcers (open sores). Cutting the callus on your own could lead to wounds and infection.

Treatment Options

Foot ulcer treatment and wound care management involves a multidisciplinary approach. A physical examination of the foot will help evaluate the perception of superficial pain, temperature sensation, light sensation and pressure. Nurses must make sure to document the wound assessment and further details using an advanced wound EMR to monitor the progress of the patient’s condition.

  • Medications – If infection progresses, the physician may recommend antibiotics, antiplatelets, or anti-clotting medications to treat the ulcer
  • Surgical debridement – Debridement is recommended in all chronic wounds to remove surface debris and necrotic tissues that can inhibit healing. The process can:
    • Create a fresh wound bed
    • Improve healing by promoting the production of granulation tissue

    Wound debridement modalities may be surgical, autolytic, enzymatic, ultrasonic, mechanical and maggot. Autolytic debridement involves the use of dressings such as hydrocolloids, hydrogels, and films that create a moist wound environment.

  • Negative-pressure wound therapy (NPWT) – Utilizeing a vacuum dressing to promote healing in acute or chronic wounds is another treatment for diabetic foot ulcers.

Even a mild injury can result in a foot ulcer in individuals with diabetes. When diabetes is controlled well, you are less likely to develop any such complications. To prevent foot ulcers and its related risks, make sure to wear shoes that fit properly and have plenty of room in them, and also notify your physician if you suspect any foot problem.